Swivelling fracture orthosis

ABSTRACT

A rolling fracture orthesis, including a shell that is roll-flexible in a circumferential direction to surround a limb to be supported, the shell having adjacent bend-resistant strips that are pivotably interconnected and arranged parallel to each other in a longitudinal direction. Hook and pile fastener tapes are arranged to hold the strips together. A breathable, skin-compatible material is applied to only an inner side of the strips. The hook and pile fastener tapes are passed completely around an outer circumference of the shell always in a same direction of application.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention relates to a rolling fracture orthesis, especially ahumerus fracture orthesis (upper arm orthesis), such as is for exampleapplied after a fracture between the proximal and distal third of thehumerus shaft, either on the day of the injury or during subsequenttreatment after the initial immobilization dressing has been removed.

2.Discussed of the Prior Art

Ortheses of this type are, for example, described in the leaflet 2/90“MANUAL for the functional conservative treatment of fractures with theMiami fracture orthesis system according to Sarmiento Latta” from thecompany Thämert, 30938 Burgwedel. The humerus fracture orthesispresented and described therein, the Miami system, comprises twogutter-shaped half shells that enclose the upper arm between the axillaand elbow and are held together by hook and pile fastener tapes togetherwith plastic loops. These half shells are prepared from perforated,smooth, waterproof plastic and are applied over a double cotton tubepreviously pulled on from the elbow to the axilla. When applying, theanterior shell is first applied, then the posterior shell, after whichtwo hook and pile fastener tapes set at a distance from each other alongone long side are passed through plastic loops on the anterior shell andare then passed through other plastic loops attached at suitableintervals along the second long side of the posterior shell and areturned back by 180° and fastened. The tapes are thus firmly fixed ononly one side so that, apart from painful drawing, displacement of theorthesis can be caused. In addition, the orthesis fixed in this way candisplace along its longitudinal direction on the underlying cotton tubeso that it slips downward, its seating becomes loose and an obstacle tobending the elbow is created. The orthesis then has to be constantlyundone and pushed up to the correct position and the tapes fastenedagain, which can be painful and also may have an adverse effect on thefracture. In addition, the known orthesis provides no control over themovement of the upper arm. A previous plaster cast (immobilizationdressing) that is also applied after the fracture possesses a cap thatleads over the shoulder. When the patient comes up against the capduring movement of his arm, he knows that he must immediately lower hisarm.

In this respect it is to be noted that humerus fracture ortheses, whichare increasingly being applied in accident surgery departments andclinics to fractures not surgically treated, have to be manufactured andbe available in three or four sizes (S, M, L and XL) and also inversions for the left and right arm. The storage space required for thevoluminous shells or hollow bodies in the assembled state is certainlyvery great when it is considered that a total of eight models (foursizes, each for right and left) have to be stocked.

This leaflet also presents a tibia fracture orthesis (lower legorthesis) which has a heel cap for fixed positioning of the tibiaorthesis. After prior determination of position, the heel cap isfastened to the posterior orthesis shell by non-detachable adhesivestrips. If this fixation is not undertaken correctly, readjustment withrespect to height of the orthesis or cap angle is no longer possible.

U.S. Pat. No. 4,863,968 also presents an ulna fracture orthesis (forearmorthesis) in which an L-shaped moulded hand limitation cap is attachedto the lower shell and ensures that the hand is held approximatelyperpendicular to the forearm. This hand limitation cap is fixed to thelower shell in the definitive position by ratchet rivets which providean initial adjustment but do not allow subsequent readjustment.

A device for immobilization and provision of heat or cold to a bodilyjoint is known from U.S. Pat. No. 4,753,240, comprising a flexibletextile cut-out that is placed around the arm or leg and is heldtogether by hook and pile fasteners facing each other on thenon-overlapping ends. This shell is very soft not only in the transversedirection but also in the longitudinal direction, except for a thin,central longitudinal segment, e.g. at the heel or shoulder, where anadapted, angled shape can, if required, be applied by the insertion ofinelastic, bendable metal rods. A firm, even hold with greatlongitudinal rigidity that must be ensured on the day of injury or as afollow-up treatment can therefore not be achieved with this knowndevice.

U.S. Pat. No. 4,492,225 describes neck supports and arm splints formedfrom multilayered material. Thus, for example, for an arm or leg splintsome inelastic, easily deformable metal strips, e.g. thin aluminumstrips, are applied to the inside of an external hard foam plate and arecovered with a thick internal cushioning layer of foam to give amaterial thickness of at least 25 mm. In addition, the relativelywide-apart, broad margins of the applied supports are held together onlyby a few short hook and pile fasteners so that in all and not leastbecause of the pliant inner padding about 20 mm thick, adequatelongitudinal stability cannot be achieved with these known supports.

A portable buttock and leg splint is described in U.S. Pat. No.4,580,555 that comprises a long, thin cut-out composed of two layers ofNylon material into which a row of parallel, flat rods are sown inlongitudinal pockets. When applying, the patient sits on the orthesisand the two relatively short side margins that do not cover t uppersurface of the leg are drawn up and, by means of upper tension bands,fix the leg to the base. Apart from the fact that the flat rods usedappear to be relatively broad and are present in only one part of thesupport surface, the fact that the support incompletely surrounds a limbmeans that its use as an upper arm orthesis, for example, cannot besensibly achieved.

U.S. Pat. No. 2,138,975 describes a surgical splint composed of severalunits, that can be optionally lined up against each other and, throughdouble joints that can be fixed in any position, can be pushed togetherto form a solid, inflexible plate or folded to form a small packet. Dueto the great width of the parts, this known splint cannot be used for afracture orthesis with a shell that is bend-resistant in thelongitudinal direction.

An inflatable arm splint is described in U.S. Pat. No. 1,101,076,composed of a flat, foldable part with long edges that, when wrappedaround an injured leg for example, fit together like a tongue-and-groovejoint and are held together by a clip to form a pneumatic cuff. Thisinflatable emergency splint can be used only for a short time until aplaster cast is applied and is not for longer use, especially as it doesnot ensure adequate longitudinal stability.

A dressing splint is known from DE-GM 1,750,875 with longitudinal metalbars connected by cross-pins and comprising elastic, mat-shaped plasticparts bearing large gaps, and which can be fitted together if required.This elastic dressing splint is applied directly to the limb requiringsupport, and is held in place by winding round with a bandage. Thisknown dressing splint is not suitable as an orthesis that patients canapply themselves if necessary and that exhibits adequate longitudinalrigidity.

A splint is described in U.S. Pat. No. 2,273,028 that is composed ofcorrugated, perforated plastic material that is cut out as required,applied and fitted with appropriate bandages for fixation. A provisionalsplint made from this material cannot be worn for long periods andcannot be re-applied by patients themselves when necessary.

Finally, U.S. Pat. No. 1,964,694 discloses a surgical splint composed ofseveral rigid, perforated shell parts, whereby the shells are alignedtogether in a transversely adjustable manner by means of a rectangularangle unit together with elongated holes and wing-nuts. This knownorthesis cannot be used as a complete orthesis embracing the entirecircumference of a limb and providing optimum immobilization.

SUMMARY OF THE INVENTION

The object of the invention is therefore to provide a rolling fractureorthesis, especially a humerus fracture orthesis of the above type,whereby with a simple construction it is possible to obtain reliable,actively breathing immobilization of the limb segment by only twoorthesis designs (left and right) that cover all sizes and can betightly rolled up, and that can be applied and worn easily, with precisepositioning and resistant to displacement, with optimal readjustment ofposition.

Accordingly, the roll-flexible orthesis is formed of single shell thatis composed of several adjacent bend-resistant strips that are pivotablyinterconnected and arranged parallel to each other in the longitudinaldirection, whereby a breathable, skin-compatible material such as cottoncloth is applied, e.g. by adhesive, only to the inside of the strip, andthe hook and pile fastener tapes that fully encompasses the outercircumference of the overlapping shell to hold it together in theapplied state always run in the same direction as the application orpull. A rolling shell, i.e. a flexible “rolling humerus fractureorthesis” that is bend-resistant in the longitudinal direction and canbe rolled up tightly is created in this way. In the removed state, thisrolling shell can be laid flat on a support such as a table and/or canbe rolled up tightly into a roll for packing in a box or any containerfor clearing away and thereby saving a great deal of room. Because therolling shell can be easily adjusted to any arm thickness and can besimply applied to any arm no matter how thin or thick, whereby its twolong ends then merely overlap to a greater or lesser extent, it ispossible to provide the inventive orthesis in just a single size, i.e.in only two models, namely a left model and a right model. Instead ofthe previous eight models, now two models are sufficient. This thusprovides the great advantage of reducing the space and the number ofunits required, especially with regard to storage and preparation. Theapplication of the inventive rolling orthesis is also extremely simplesince essentially its middle is applied along the arm and the two endsare wrapped firmly around the arm and overlap, after which the rollingshell is fixed to the arm by means of hook and pile fastener tapes,preferably two tapes. In addition, because the hook and pile fastenertapes are passed completely around the outer circumference of ted,applied rolling shell, always in the same direction of application orpull, without change of direction, gentle application and fixationwithout jerky pulling back or lashing down is achieved with these tapes.In additional advantageous designs, even greater reliability ofapplication and wearing is achieved by means of at least one metal orplastic loop and one or more hook and pile fastening points around thecircumference. Instead of the relatively cumbersome guide loops, justone or more peripheral-humps, burls, etc., each arranged in pairs, canallow the positional fixation or guidance of the tapes around the shell.

It is advantageous if the strips of the rolling shell are made ofplastic, wood or metal, or a combination of these materials. The choiceof material can be made individually depending on the criteriaconsidered most important, such as price, environmental friendliness,etc.

The strips are preferably made from hard material such as hard plasticand are about 9 mm wide and about 3 mm thick.

It is of further advantage if an air-permeable, tear-resistant, flexiblesupport material such as cotton-canvas, woollen cloth or other textileis applied or attached by adhesive to one side of the strips. Thetextile support material plays two roles, the first being to act as abreathable, non-slip and skin-compatible internal liner so that priorapplication of a cotton tube to the upper arm is no longer necessary. Inaddition, the support material simultaneously acts as a pivot or jointelement between the bend-resistant strips and allows the rolling shellformed in this way to be rolled up as a tight roll with the supportmaterial on the inside of the roll. The small gaps between the stripsalso allow exchange of air through the textile support material and thisinhibits sweating. The cotton tubes previously used under plastic shellsare not needed since the material (cloth) from which the flexiblerolling shell is made is skin-compatible.

In another embodiment the strips may be joined together directly byjoints, i.e. without intermediate foreign material, whereby each stripexhibits on its two long-thin sides a joint element, thus a shaft partand a joint socket or joint cup part. These parts may be of variousdesigns, whereby any effective known design of known joint connectionsbetween corresponding strips, rods, etc. may be used, especially rollershutter, venetian blind and roll-fronted cupboard designs, etc. Inaddition, the essentially cylindrical joint socket and the joint shaftthat fits into this socket in a swivellable manner extend along theentire length of the strips or boards, whereby the joint shaft may,depending on the strength requirement, be in one piece or be dividedinto several parts at intervals. In all cases it is important that thestrips can swivel sufficiently between each other and that the stripsare held together adequately in the transverse or tangential direction.

The strips may be prepared from solid material or from the hollow boxforms with internal stiffening ribs known in the roller-shuttertechnique. In the latter design with internally stiffened hollow boxforms, the joint shaft is formed as a hook that engages in a swivellablemanner in the narrow-sided joint socket of the adjacent strip and can bedisplaced in the longitudinal direction (by known means can be lockedfrom longitudinal movement after fitting together) and also can beslightly displaced inside the socket in the tangential or transversedirection with some play. Apart from a relatively recent method ofmanufacture in the case of plastic material preparation, e.g. byextrusion, very great further advantage is achieved in that with therolling shell already applied, the shell can be drawn somewhat closer bythe tapes since the individual strips may be pushed close or drawnfurther apart at the joints. If, after applying and fastening the shellit is found that it is sitting a little too loosely, it is thus notnecessary to remove the entire shell but only necessary to release thetapes a little, e.g. to the next fastening point, and then draw themrather more firmly over the periphery so that the strips close up andthe circumference is reduced overall and the rolling shell achieves afirmer seating. A firm, constrictive seating that could stop the bloodcirculation in the arm can be easily and quickly adjusted by partialloosening and then looser fastening of the tapes without the patientrequiring special additional help or even without having to reapply theorthesis.

In another embodiment, the inventive rolling shell may be prepared inone piece practically from the same piece of material, whereby thestrips and the interconnecting joints are produced by arranging thinnerbending bridges between the strips.

These bending bridges between the strips may be thinner interconnectingbridges located either at the inner base of the strips or higher up atmid-height between the strips. If the bridges between the strips are atmid-height it is of great advantage that a one-piece, roll-flexible andsimultaneously longitudinally rigid part is obtained that exhibits thesame good rolling or flexibility properties on both sides. In this waythe same shell shape can be cut out for preparation of the left andright models, whereby only the subsequent application or attachment ofthe tapes, fixing points and loops determines whether it is a left orright model. However, this can also be determined at a later stage byapplying adhesive strips to suitable points marked for right or left sothat, if necessary, a left or right orthesis can be prepared on sitewith a little manipulation. As a result, with this design only a singleembodiment is required instead of the previous eight embodiments. Itshould be noted that this is very advantageous both in terms of cost andin terms of storage, which itself also has a noticeable effect on costs.

The inventive rolling orthesis can finally also be produced in aone-piece form such that the bending bridges between the strips areformed as arches curving outwards, whereby the strips are approximatelyas thick as the arches. In all, a roughly corrugated sheet form isobtained with the corresponding properties and certainly goodflexibility in the transverse direction and great rigidity in thelongitudinal direction.

In all these embodiments with direct connection between the strips, i.e.without textile support material, as already noted a breathable andskin-compatible inner lining, preferably of textile material, is appliedto the inside of the bridges. Holes and/or slits should also be providedin the bridges or connecting parts for adequate ventilation. Good aircirculation can be achieved through the hollow channels formed under thebridges in an embodiment with bridges raised above the applicationsurface and additionally presenting slits or holes.

It is of particular advantage if, in the embodiment of the orthesis as ahumerus fracture orthesis, a shoulder retention cap which is essentiallyL-shaped or adapted to the shoulder-arm outline is secured to the outerpart of the rolling shell applied to the arm, and its position can beadjusted. This shoulder retention cap is secured essentially in themiddle of the upper shell zone so that it follows the outer contour ofthe arm, essentially vertically at first, and then runs like a cap overthe shoulder so that its upper section is essentially verticallysupported on the shoulder. This prevents the orthesis slipping downsince there is always vertical support. There is also additional controlof the movement of the upper arm by the patient.

The use of orthesis retention caps or elements to counteractlongitudinal displacement of ortheses is certainly known. However, afterprior adjustment to the corresponding longitudinal position they aredefinitively secured so that any longitudinal displacement or swivellingof the cap that is subsequently required is no longer possible. Thepatient has to make do with the position of the orthesis once it isdetermined, even if this position is not optimal.

The inventive shoulder retention cap advantageously exhibits a longvertical guide arm and a short roughly horizontal supporting arm thatrun into each other in an arch shape. At its outer end the supportingarm exhibits a cushion formed as a round foam rubber pad or a long strippad over the entire longitudinal strip leading from the shoulder arch.The round pad is preferred since it provides more accurate verticalsupport.

The longer guide arm of the shoulder retention cap is secured by itslower end section that is shaped to fit the shell and lies overlappingon the shell; it is secured in such a way that it can be shiftedlongitudinally and can be swivelled vertically/longitudinally. Whererequired, this allows pre-adjustment or re-adjustment of the orthesisposition relative to the shoulder. Because the shoulder retention cap iseasily swivelled, optimal support can also be achieved on the shouldersince the position of the shoulder varies from person to persondepending on their posture, i.e. depending on how curved the back orshoulders are.

The displacement and/or swivelling capacity of the shoulder retentioncap over its guide arm on the shell is preferentially achieved in thattwo parallel longitudinal guide slots are present on the lower endsection of the guide arm overlapping the shell and are each traversedperpendicularly by a bolt that is firmly anchored in the shell. Theconnection can be undone or secured quickly by means of wing nuts ormilled nuts that fit onto these bolts, i.e. nuts that can be operatedwithout tools but by hand quickly and without particular force. Aftersuccessfully applying the orthesis, by slightly loosening the screwconnections the patients can thus themselves shift the shoulderretention cap in the longitudinal direction and/or swivel it slightlyfurther forward or back from the vertical position so that optimalsupport and very good wearing comfort are achieved with optimal seatingand wearing properties of the orthesis.

It is also advantageous if the shoulder retention cap is gutter-shapedwith essentially the same radius of curvature as the shell in theapplied state or is slightly transversally elastic to allow tangentialdeformation when applying and removing the orthesis, and if it is madeof essentially the same material as the strips of the rolling shell andpreferably of waterproof plastic fitted with air holes.

Pleasant wearing properties are achieved if the upper end of the supportarm of the shoulder retention cap is rounded off as a semi-circle and atthe same time the round pad follows the contours to some degree.

The invention is explained in more detail below on the basis of severalembodiment examples and with reference to the drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The figures show:

FIG. 1: a lateral view of an applied rolling orthesis with shoulderretention cap;

FIG. 2: an anterior perspective view of an orthesis according to FIG. 1;

FIG. 3: a posterior view of the orthesis according to FIGS. 1 and 2;

FIG. 4: a plan view of an orthesis according to FIGS. 1-3 in thelaid-out, flat, unrolled state, in the embodiment for the right arm;

FIG. 5: a partial section through line V—V in FIG. 4;

FIG. 6: a partial section through line VI—VI in FIG. 4 in a furtherembodiment (roller-shutter design);

FIG. 7: a partial plan view of a partial section at arrow VII in FIG. 6;

FIG. 8: a view of the narrow longitudinal side of a rolling shell stripat arrow VIII in FIG. 7;

FIG. 9: a partial view in the longitudinal direction of a rolling shellin a further embodiment;

FIG. 10: a plan view at arrow X in FIG. 9;

FIG. 11: a partial view in the longitudinal direction of a rollingorthesis in a further embodiment with straight bending bridges;

FIG. 12: a plan view of the embodiment according to FIG. 11;

FIG. 13: a partial view in the longitudinal direction of a rolling shellwith arch-shaped bridges, and

FIG. 14: a plan view of the rolling shell according to FIG. 13.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

As illustrated in FIGS. 1-4, in which the inventive orthesis is shown inan embodiment as a humerus fracture orthesis, this orthesis comprises asingle, roll-flexible shell 1 (rolling shell) which is appliedoverlapping around the upper arm and is fixed in place with two hook andpile fastener tapes 5. The hook and pile fastener tapes are thereby heldin position on the rolling shell 1 by means of hook and pile fasteningpoints 6 and plastic or metal guide loops 7. The tapes 5 thereby alwayspass in the same peripheral direction around the applied rolling shell 1and are fixed at their outer end to the corresponding upper hook andpile fastening point at the start of the tape.

As can be seen particularly in FIG. 4, in which the vi orthesis isillustrated as an embodiment of the orthesis for a right arm, therolling shell 1 shows various cutouts at the upper and lower edges thatallow optimal seating with regard to the axilla and elbow. The hook andpile fastener tapes 5 are secured to one side or half of the rollingshell 1 and on their upper side they each show a hook and pile fasteningpoint 6 on their end that is firmly secured to the rolling shell. On theother half of the shell are the guide loops 7 through which the tapes 5are passed to be fixed in position after applying the shell 1.

As can be seen from FIGS. 1-4 and particularly from FIG. 4, a shoulderretention cap 2 is secured in the upper zone of the rolling shell 1 andcertainly essentially in its middle, this cap being essentially L-shapedand approximately follows the shape and curvature of the shoulder-armline. It is composed of a guide arm 2 a running approximately verticallyin the applied state and a horizontal upper support arm 2 b that mergeinto each other via an intermediate curved part.

At the lower end of the guide arm 2 a that overlaps the shell are twoparallel guide slots 3 running vertically or longitudinally, througheach of which passes a bolt 4 that is secured to and projectshorizontally from the shell 1. Onto each of these bolts 4 fits awing-nut 9, under which is a washer 10, as can be seen more precisely inFIG. 10, in order to provide good support for the nut.

Underneath the upper, rounded end of the support arm 2 b is a round pad,e.g. of foam rubber or formed as a foam rubber-filled cushion 8. Thisensures comfortable vertical support of the orthesis virtually at onepoint.

As can be seen from FIGS. 1-5, especially FIG. 5, the rolling shell 1 ofthe inventive orthesis can be composed of a flexible support material 12that, for example, may be a firm cotton-canvas material. On this supportmaterial 12 are applied, e.g. by adhesive, plank-shaped, bend-resistantstrips 11 close together in parallel to form the shape of the flexiblerolling shell 1. The thin intermediate gaps between the strips 11 allowgood air exchange and inhibit sweating.

In the embodiment illustrated in FIGS. 6-8, the strips 11 are connectedtogether directly by joints, whereby joint shafts 13 are provided on oneof the long thin sides and engage in the joint sockets 14 or housing onthe other long thin side. The shafts 13 and housings or sockets 14 areessentially cylindrical in form in this embodiment and, as may be seenfrom FIGS. 7 and 8, can be formed as one continuous piece or be dividedinto several pieces. A breathable, skin-compatible inner lining 20 isapplied, e.g. by adhesive, to the inner side of each strip 11.

From FIG. 6 it can also be seen that, for example, the shoulderretention cap 2 is secured to the rolling shell 1 by bolts 4 and nuts 9,here wing nuts, with underlying washers 10.

In the embodiment according to FIGS. 9 and 10, the strips 11 are formedas hollow boxes with internal strengthening ribs 17. The joint shafts 13are formed as hooks that engage in the housing openings or joint sockets14 in such a way that these latter tightly enclose the thin fasteningbridges of the hooks, whereby the hook length is adapted to the depth ofthe joint socket so that at least slight tangential or transverse to andfro movement of the strips is possible through their swivellingconnections. It can be seen from FIG. 9 that the strips 11 may exhibit acurvature matching the circumference. FIG. 10 shows that ventilationslits 15 are present in the hook base to ensure good air circulation.

In the further embodiments illustrated in FIGS. 11 and 12, the strips 11are connected to each other in an elastic-bendable manner by bridges 18,whereby the bridges 18 are essentially present in the middle of thestrips 11. As can be seen in FIG. 12, there are slits 15 or holes 16 inthe bridges 18 and/or in the strips 11 to provide good ventilation.

Finally, FIGS. 13 and 14 show a last embodiment in which externallybowed arches 19 are provided as elastic bridges between the strips 11.These arches 19 particularly allow flexibility in the circumferentialdirection and, if required, allow rolling up toward the inside, andenhance the longitudinal rigidity in the same way as corrugated iron orcorrugated cardboard.

In all embodiments according to FIGS. 6 to 14 it can be seen that abreathable inner lining 20 is applied, e.g. by adhesive, to the strips11 on the inside of shell 1.

Finally it should be noted that the inventive rolling orthesis can beused in technically the same embodiments but without the shoulderretention cap as an ulnar fracture orthesis (forearm orthesis) and, witha heel cap instead of the shoulder retention cap, as a tibia fractureorthesis (leg orthesis) with just minor alteration of the contours(distal and proximal) of the rolling shell.

What is claimed is:
 1. A rolling fracture orthesis, comprising: a shellthat is roll-flexible in a circumferential direction to surround a limbto be supported, the shell having adjacent bend-resistant strips thatare pivotably interconnected and arranged parallel to each other in alongitudinal direction; hook and pile fastener tapes arranged to holdthe strips together; and a breathable, skin-compatible material appliedto only an inner side of the strips, the hook and pile fastener tapesbeing passed completely around an outer circumference of the shellalways in a same direction of application.
 2. An orthesis according toclaim 1, wherein the strips are made from at least one of plastic, woodand metal and are about 9 mm wide and about 3 mm thick.
 3. An orthesisaccording to claim 1, wherein the support material is air-permeable,tear resistant and flexible.
 4. An orthesis according to claim 1,wherein the strips are directly joined to each other by joints, eachstrip having a laterally projecting, at least partially cylindricaljoint shaft running longitudinally along one long-thin side of the stripand a cylindrical joint socket running longitudinally along an oppositelong-thin side of the strip so that the joint shaft of one strip engagesin the joint socket of an adjacent strip so that it is longitudinallydisplaceable and swivellable but cannot be pulled out in acircumferential direction.
 5. An orthesis according to claim 4, whereinthe joint shaft is formed as one piece in the longitudinal directionwith one of longitudinal ventilation slits and holes.
 6. A. An orthesisaccording to claim 4, wherein the joint shaft is formed of several jointshaft pieces provided at intervals in the longitudinal direction.
 7. Anorthesis according to claim 4, wherein the strips are made of solidmaterial.
 8. An orthesis according to claim 4, wherein the strips arehollow in crosssection and have internal strengthening ribs.
 9. Anorthesis according to claim 4, wherein the strips are formed fromroller-shutter elements, whereby the joint shaft projecting from onethin side is shaped as a joint hook on one strip and engages in aswivellable manner in the joint socket on the thin side of the adjacentstrip so that it can be displaced in the longitudinal direction andadditionally can move slightly inside the other with some play in one ofa tangential and circumferential direction.
 10. An orthesis according toclaim 1, wherein the strips are joined together by thin flexible bridgesof a common material with the strips, at least one of the bridges andthe strips having aeration and ventilation openings.
 11. An orthesisaccording to claim 10, wherein the bridges between the strips are short,straight bridges.
 12. An orthesis according to claim 10, wherein thebridges between the strips are formed as outwardly bulging arches,whereby the strips exhibit a thickness approximately equal to thearches, whereby a complete unit is formed that is laterally flexible andlongitudinally rigid.
 13. An orthesis according to claim 1, and furthercomprising a shoulder retention cap mounted to an outer section of therolling shell in a positionally adjustable manner.
 14. An orthesisaccording to claim 13, wherein the shoulder retention cap is L-shaped.15. An orthesis according to claim 13, wherein the shoulder retentioncap is formed to match a course of an arm-shoulder outline.
 16. Anorthesis according to claim 13, wherein the shoulder retention cap, in amounted state, has a long, vertical guide arm and short, horizontalsupport arm that run together in an arch-shaped portion.
 17. An orthesisaccording to claim 16, and further comprising a pad mounted on anunderside of an outer end of the support arm.
 18. An orthesis accordingto claim 17, wherein the pad is circular.
 19. An orthesis according toclaim 17, wherein the pad is a strip that runs along the entirearch-shaped portion.
 20. An orthesis according to claim 16, wherein theguide arm has a lower end section secured in overlapping fashion on theshell so that the guide arm can be displaced longitudinally and swivelslightly in the vertical/longitudinal directions.
 21. An orthesisaccording to claim 20, wherein two longitudinal guide slots parallel toeach other are provided on the lower end section of the guide arm, andfurther comprising perpendicular bolts arranged to pass through each ofthe slots and secured in the shell so that a nut can be screwed firmlyonto a projecting end of each bolt.
 22. An orthesis according to claim13, wherein the shoulder retention cap is gutter-shaped with a commonradius of curvature with the shell in an applied state and is made ofthe same material as the strips of the rolling shell.
 23. An orthesisaccording to claim 22, wherein the shoulder retention cap is made ofwaterproof plastic and has ventilation holes therein.
 24. An orthesisaccording to claim 22, wherein the shoulder retention cap isgutter-shaped and is transversely slightly elastic to allow deformationwhen applying and removing the orthesis.
 25. An orthesis according toclaim 13, and further comprising a breathable, skin-compatible innerlining fitted on an inner side of the rolling shell, the strips and thecap.
 26. An orthesis according to claim 25, wherein the inner lining isone of a textile, a cotton tissue, and a plush lining.